Provider Demographics
NPI:1710228341
Name:BAKER, NATASHA CAITLIN ANN (BS)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:CAITLIN ANN
Last Name:BAKER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17788 COUNTY ROAD 97E
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-9367
Mailing Address - Country:US
Mailing Address - Phone:530-312-2123
Mailing Address - Fax:
Practice Address - Street 1:750 F ST STE 2
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-3738
Practice Address - Country:US
Practice Address - Phone:530-758-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA 16102355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant